Provider Demographics
NPI:1801609540
Name:THOMAS, KATHLEEN ERIN (LPN)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:ERIN
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:ERIN
Other - Last Name:KARPOICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 BATES LN
Mailing Address - Street 2:
Mailing Address - City:SHOREHAM
Mailing Address - State:NY
Mailing Address - Zip Code:11786-2327
Mailing Address - Country:US
Mailing Address - Phone:631-764-2692
Mailing Address - Fax:
Practice Address - Street 1:1 BATES LN
Practice Address - Street 2:
Practice Address - City:SHOREHAM
Practice Address - State:NY
Practice Address - Zip Code:11786-2327
Practice Address - Country:US
Practice Address - Phone:631-764-2692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY323691-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse